• Journal of Korean Academy of Nursing
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• v.42 no.2
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• pp.181-189
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• 2012

Purpose: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm ($34{\leq}GA<37$) and preterm infants (GA<34). Methods: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Results: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Conclusion: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.

• Journal of Korean Public Health Nursing
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• v.3 no.1
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• pp.38-60
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• 1989

The present analysis was undertaken to find out the relationships between birth weight & Apgar Score of newborn infant & maternal factors. The medical records of 1436 newborn infants who had been at the Korea University III Seoul from January. 1.1984. to December. 31. 1985, were examined. Measurements include weight and Apgar Score. As the possible factors influencing the birth weight & Apgar Score of newborn infant, 9 variables such as : mother's age, frequency ·of pregnancy, frequency of fullterm delivery, frequency. of premature, frequency of abortion, mother's hemoglobin level, complications during pregnancy gestational period and infant sex at birth were selected among the items recorded in the medical records of newborn infants and their mothers. The weight & Apgar Score of newborn infants were compared separately by sex with group percent of those variables. The results were summarized as follows: 1. All of those factors chosen are supposed to be influencing upon the birth weight and Apgar Score examined at birth indirectly through inducing early termination of pregnancy. 2. The most influencing variable of birth weight of newborn infants was gestation period. The most influencing variable of Apgar Score of infant newborn was gestation period. 3. The relationships of those influencing factors are more clear on the birth weights of newborn than on the Apgar Score. 4. More then half of low birth weight infants are turned out to be physiologically normal through the evaluation by Apgar Scoring. Conclusively, All of those factors chosen are supposed to be influencing upon the birth weight and apgar score examined at birth indirectly through inducing early termination of pregnancy.

• Neonatal Medicine
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• v.28 no.3
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• pp.124-132
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• 2021

Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

• Korean Parent-Child Health Journal
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• v.7 no.2
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• pp.144-159
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• 2004

Purpose: The purpose of this study is to explore mother's perception and practice of Taegyo. In addition, belief factors toward Taegyo oriented Korean mother-fetus interaction are identified in order to obtain baseline data for the development of Taegyo oriented program enhancing mother-fetus interaction. Method: The sample consisted to 186 pregnant women who visited public health center or hospital for prenatal care. Self-reporting questionnaire devised by investigator was used. Data were analyzed by SPSS win program and contents analysis was used. Result: Although mothers intended to a pregnancy, many of them were perceived negatively toward pregnancy. The study revealed that most of pregnant women continued cultural practices related to Taegyo, they focused on mother-fetus interaction behavior-such as listen to the music, reading a book, talk to fetus, stroke the fetus- with being altered traditional beliefs toward Taegyo or Taemong. Most of pregnant women had Taemong and believed a it's predictive functions. Beliefs toward mother-fetus interaction were classified to 6 factors, pregnancy, Taemong. fetus, practice behavior, infant's abilities and mother-fetus interaction behavior. The scores of belief toward mother-fetus interaction and each factors of pregnancy, fetus, practice behavior, infant's ability were statistically significant different depending upon husbands education. Also pregnancy factor in belief toward mother-fetus interaction was statistically significant different depending upon the number of children, child birth, experience of abortion, premature birth. Conclusion: Developing Taegyo oriented program enhancing the mother-fetus interaction need to include the elements of being facilitated maternal identity formation and maternal confidence for the pregnant women. In addition, it should be developed the program concerning with the characteristics of the pregnant women.

• Child Health Nursing Research
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• v.12 no.2
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• pp.204-214
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• 2006

Purpose:　The purpose of this study was to investigate the effects of Yakson therapy conducted by mother of preterm infants on the maternal attachment and attachment behavior. Method: A quasi experimental pre-post test design was used. The data were collected from January, 2005 to October, 2005. The participants were 30 mothers of preterm infants hospitalized in a neonatal intensive care unit (15 in the Yakson therapy group and 15 in control group). Yakson therapy consists of three phases: laying a hand, caressing by hand, and laying a hand again taking 5 minutes for each phase. Yakson therapy was provided to infants in the experimental group for 15-minutes 5 times for 15 days. Data were analyzed using the SAS program with x2-test, repeated measures ANOVA, and Fisher's exact test. Result: Compared to the control group, the experimental group had significantly higher scores in maternal attachment (F=5.54, p=.0258). And the attachment behavior of the experimental group was higher than that of the control group. Conclusion: The results suggest that Yakson therapy can be used to improve maternal attachment and attachment behavior.

• Clinical and Experimental Pediatrics
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• v.57 no.3
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• pp.101-109
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• 2014

The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.3
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• pp.599-610
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• 2016

This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.

• Women's Health Nursing
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• v.5 no.1
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• pp.80-95
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• 1999

The purpose of this study was to investigate the characteristics of low birth-weight infants and their's mothers, and to identify the factors which influenced to delivery of L.B.W infants. The data derived from K. General Hospital and J. obs & gyn clinic in pusan from January, 1998 to August, 1998, which were from mothers of having B. W infants. The factors used for this study were characteristics of general, obstetrical, environmental aspects and physical and psychological life experiences during pregnancy. Analysis of data obtained were computerized statistically by using SPSS 7.5 WIN program. the data were analysed as number, frequency, percentage, t-test and ANOVA. The major results obtained of this study were as follows : 1) Gender that L.B.W infants were male in 47.2% and female in 52.8%, body weight of 2001~2500gm was above 8 in 68.5%, and below 5 in 1.8%. The L.B.W infants with complications were 7, which were 6.5%. The kinds of malformations were the Cleft palate & lip, Hyper-kalemia, Hypoglycemia, Meningocele, CHD, Down syndrome and each of them marked 0.9%. 2) In the general characteristics of pregnant women, the age group of 25~29 years was the most common as 46.3%. Over 35 years of age, elderly gravidas were in 7.5%. the height of 156~160cm was the most common as 52.8%. pregnant women of below 150cm height was in 3.7%. body weight of 51~55kg was the most common as 38%. pregnant women of below 45kg were in 19.4%. The women with smoking and drinking episodes during pregnancy were 1.9% and 25%. In the status of marriage, married women were in 95.4%, unmarried ones were in 1.9%, and unmarried couples were in 2.8%. Iin he obstetrical characteristics of pregnant women, pregnant women with gestational age under 37wks were in 45.4%, and the ones over 38wks were 54.6%. At the methods of delivery, normal spontaneous vaginal deliveries were in 51.9%, which were the most common, cesarian section deliveries were in 47.2%, and breech deliveries were in 0.9%. In the environmental characteristics of pregnant women, 40.8% of pregnant women lived in house or apartments with stairs, 23.1% of them lived in the high altitude. the pregnant women who ran a household without a helper were in 65.7%. In the pregnant women who had underwent life experiences of physical and psychological stress during pregnancy. life experiences of physical stresses were described as persistent fatigue due to lifestyle, traumatic experience, illness, move away with an effort, physical impact caused by discord. life experiments of psychological stresses were describeded as trouble with their husbands, discord with one's husband family, family problems, and conflicts due to environmental factors, etc. The number of the pregnant women who had complications during pregnancy was 32, which was 29.6% totally. Among them, pre-eclampsia was in 12.1% and the premature rupture of membrane in 7.4%. 3) In the analysis of the general, obstetrical, and circumstantial characteristics and L.B.W infants. There were statistical difference significantly between the gestational age of pregnant women(F=12.035, P=.000), and the status of marriage(F=3.207, P=.044), and maternal complication(t=2.344, P=.021) etc.

• Child Health Nursing Research
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• v.4 no.1
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• pp.60-75
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• 1998

The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

• The Korean Nurse
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• v.30 no.3
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• pp.49-65
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• 1991

This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situaition. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, $x^2$-test, F-test, Pearsons correation, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants(42.7%) were born to mothers with risk-scores > 7, and 753 infants(57.3%) were born to mothers risk-scores <7. 2. Maternal age" parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies($X^2$=20.88, 42.87, 15.60 P < 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infanl, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. ($X^2$ = 175.96, 87.5, 16.28, 21.78, 9.46, 8. 10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P < 0.01). 4. Abnormal nutrition, anemia, UTI, other medicalcondition(pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 '||'&'||' 5 minute after birth and neonatal body weight. 6. Apgar score at 1 '||'&'||' 5 minute after, birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 '||'&'||' 5 minute after birth, 3 group(0-3, 4-6, above 7), and neonatal body weight, 2 group(below 2.5kg, the other group) (F=104.65, 96.61, 284.92, P<0.01). 8. Apgar score at 1 '||'&'||' 5 minute after birth(below 7), and neonatal body weight(below 2.5kg), were significant relation statistically with risk score.($x^2$=65.99, 60.88, 177.07, P<0.01) were 60.8 %, 60% . 9. Correct classifications of morbid infants(l '||'&'||' 5 minute Apgar score < 7) were 77.8%, 83.8% and that of nonmorbid infants(l '||'&'||' 5 minute Apgar score > 7) were 60.8%, 60%. 10. There were statistically significant difference between dislribution of maternal risk-score among the morbid infants(l '||'&'||' 5 minute Apgar score < 7) and non morbid infants(l '||'&'||' 5 minute Apgar score> 7) ($x^2$=64.8, 58.8, P < 0.001). 11. There were statistically significant difference between distribution of morbid infants(l '||'&'||' 5 minute Apgar score < 7) and fetal death. 12. The predictivity for classifying high.risk cases was 12 % and for classifying low-risk cases was 98.3 % in 5 minute Apgar score. Suggestions for further studies are as follows; 1. Contineous prospective studies, using this newly revised scoring system are strongly recommended in the stetric service. 2. Besides risk facto~s used in this study, assessmenl of risks by factors in another scoring system and paralled studies related to perinatal outcome are strongly recommended.